Consultation Form
DISCLOSURE
Under the requirement of the Public Health Act 2010 (NSW) you declare that you are not suffering from, nor are a carrier of any communicable diseases, including Hepatitis B, and Acquired Immune Deficiency Syndrome (‘AIDS’).
Your dermal specialist will recommend the appropriate treatment(s) and procedure(s) to address your skin concerns and goals. Your dermal specialist may recommend that you contact your general practitioner for referral to a dermatologist or similar specialist to assist with the achievement of your skin improvement goals.
Every skin corrective method and procedure involves a certain amount of risk, and it is important that you understand the risks associated with skin correction. An individual’s choice to undergo a corrective procedure at Sydney Dermal Lounge Pty Ltd, Dermal Lounge Australia Pty Ltd, Dermal Lounge Rouse Hill Pty Ltd or its related entities (‘SDL’) should involve a comparison of the risk of undergoing the corrective procedure to the potential benefit that may result. Whilst the majority of clients do not experience any complications, you should discuss the potential risks and complications with your dermal specialist to make sure you understand the risk and potential complications associated with skin correction. By consenting with your signature, you are stating that you understand all risks involved and consent to work with your dermal specialist in the case that any should arise.
It is for each individual to consider the risk to benefit in undergoing any of our procedures. Although most procedures do not carry any long term side effects, it is important that you consider and understand these risks. The below is a list of potential complications. This list is not exhaustive. If you have concerns in relation to any of the potential risks, you should discuss this with your dermal specialist or your general practitioner before proceeding with your procedure.
PRODUCT DISCLOSURE
The products that we use are of the highest quality. The use of any of these products will only be as recommended by the manufacturer. However, depending on your skin type and your skin sensitivity, you may experience:
In the most extreme of cases, you may suffer burns. This list is not exhaustive of the potential side effects that you may experience. Contraindications that may apply to certain laser and vitamin A modalities include but are not limited to:
The below conditions are also possible contraindications which may require medical clearance prior to performing your treatment, however your dermal specialist will advise whether this is necessary during your consultation:
The below conditions may only be contraindications if the condition is in the treatment area:
Possible Side Effects of Treatments
The possible side-effects of our treatments can include:
You may also experience possible discomfort during the treatment of laser modalities, resurfacing peels, injection therapy, and topical agents.
Factors That May Hinder Results Of Treatments
The below conditions may hinder the results of treatments:
Recommended Treatments & Results
The treatment plan and number of treatments that have been recommended during the consultation appointment should be followed to obtain the results that the individual seeks. Results may vary from person to person due to factors such as individual medical history, body composition age. SDL does not guarantee results.
Whilst our treatments are devised to deliver results, they are best combined with a well maintained and healthy diet and lifestyle. In order for us to deliver exceptional service and measure your results, all clients are required to conduct body composition scans. This will provide our dermal specialists with greater detail about your individual needs and characteristics. Should you choose not to undertake a body composition scan, this will hinder our ability to assess your results as you progress through your treatment, or alter your treatment plan as needed.
You acknowledge that the best results cannot be obtained with only one treatment and our recommended treatment plan/pathway should be followed. Results can take time and can be seen from as little as 4-6 weeks of undergoing treatment and gradually over the following 8-12 weeks post-treatment. Failure to follow our recommended treatment plan/pathway (including any pre/post care instructions) as directed will affect the results achieved.
TERMS
Cancellations and Refunds
SDL Pathways
Discontinuation of SDL Pathways
Image Release Consent – for clients 18 years of age or older ONLY
I consent to SDL taking and using my photographs, video or image or photographs and videos they take of me (‘My Image’) for the purposes of advertising, media publicity, publication, training or general display, including but not limited to publication on internet web sites, social media pages and any other publications released by SDL (‘Publication’). I may revoke this consent at any time by giving SDL written notice.
I waive any interest that I may have in the copyright to My Image now or at any future time and acknowledge that I am not entitled, nor shall in the future be entitled, to receive any payment or consideration in respect of the use of My Image by SDL.
I acknowledge that SDL cannot control the unauthorised use of My Image by persons not associated with SDL upon the Publication of My Image and I release and shall indemnify SDL against any loss, damage, costs, expense, or claim (including consequential loss) connected with the Publication of My Image.
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Volume loss, enlarged pores, sun damage, and a general loss of elasticity can all affect your skin’s appearance. Very few treatments can address them all without the need for downtime. Until now. HydraFacial MD® is a gentle, non-invasive treatment consisting of multiple steps, combining cleansing, exfoliating, and hydration to reverse the visible effects of skin aging. It is also capable of producing a deep rejuvenating effect.
The treatment includes hydradermabrasion, a chemical peel, pain-free extraction, and deep hydration. During treatment, the skin receives peptides and antioxidants, which produce a natural glow and ongoing skin benefits.
The HYDRAFACIAL is suitable for all skin types and tones. It can be performed not only on the face but on the hands, back, buttocks or arms to assist with skin concerns all over the body. This treatment covers a wide range of concerns including:
SDL HYDRAFACIAL | $250
HYDRAFACIAL FIRE & ICE EXPERIENCE | $450
HYDRAFACIAL BPEEL | $350
45 – 60 Minutes
One of the main advantages of a HYDRAFCIAL in achieving your skincare goals is that it allows you to have beautifully nourished skin without any downtime. This is irrespective of where the HYDRAFCIAL is performed. No down time, instantly smooth and glowy skin.
The HYDRAFACIAL procedure is a three-step process. The first step involves a deep pore cleanse and exfoliation. The second step includes the extraction of impurities using a vortex-fusion tip. In the third step, the skin is infused with antioxidants and hyaluronic acid, with nutrients absorbing into the skin resulting in a fresher look.
Treatment reduces fine lines and wrinkles, increases firmness, evens tone, texture, and brown spots, as well as reducing enlarged pores. Its many benefits include a more hydrated, bright, plump, and clear complexion. Plus, it can also improve signs of aging.
On repeat. The HYDRAFACIAL can be completed regularly every 3-6 weeks.
Use recommended skin care to uphold your result. Your dermal specialist will base this on your skin diagnostic results and skin goals.